Sources checked: . Sources and review scope.
Cardiology billing services in Rhode Island start with the Medicare contractor listed for jurisdiction JK, National Government Services. Commercial and Medicaid coverage depends on the member's plan and product. We bill cardiology only, from Texas, at 3% of collections.
3% of collectionsNo setup feeNo contract
CMS lists National Government Services for Medicare jurisdiction JK, including New England and New York. Medicare local coverage determinations are made by the contractor for its jurisdiction; requirements may differ across jurisdictions.
Before release, we compare each claim with applicable NGS guidance. If documentation appears incomplete, we flag it for the practice to review; the treating clinician remains responsible for the record.
Blue Cross & Blue Shield of Rhode Island carries a big share of commercial patients. Neighborhood Health Plan of Rhode Island, UnitedHealthcare, Tufts Health Plan and Aetna follow. With so few plans, one payer's policy change reaches most of your schedule at once.
RIte Care is Rhode Island's managed-care Medicaid program for families with children, pregnant women, and children under age 19. The state lists Neighborhood Health Plan of Rhode Island, Tufts Health Plan, and UnitedHealthcare Community Plan as participating RIte Care plans. We confirm the member's current program and plan for each date of service.
Prior plan
Billed to the plan on that date
New plan
Billed to the member's current plan
Your patients may live 20 minutes away and still cross a state line. Many come from Fall River, Attleboro and other nearby Massachusetts towns.
Massachusetts shares the NGS jurisdiction, so the Medicare coverage rules line up. MassHealth and Massachusetts commercial plans do not, and we check each one before the visit.
Medicare physician fee schedule locality is tied to the applicable ZIP-to-carrier/locality mapping. We check the current CMS crosswalk for the service location rather than infer a rate from the state boundary.
When your local biller steps away, the change follows a 60-day plan. New claims go out from the first day. A second track works your older A/R until it clears.
Your biller learns your plans and your doctors, and stays assigned to you. You talk to someone who knows cardiology. Mon to Fri, 9 to 5 Central.
Your first 60 days with usYes. We bill in all 50 states. If your practice isn't enrolled with MassHealth yet, we tell you before the claim goes out.
We check eligibility before the study and bill the plan that covered that date.
No. You pay 3% of collections, with no setup fee and no per-claim charges.
Review context: Checked official CMS and Rhode Island EOHHS sources on September 30, 2026. This is an administrative source check, not a clinical review, a claim-level coverage determination, legal advice, or a payment guarantee. CMS's current fee-schedule page links a ZIP-to-carrier/locality file updated August 13, 2026; its separate Locality Key table is labeled 2024. No blanket statewide locality or payment assertion is made here. Confirm the applicable locality, member program and plan, provider requirements, and authorization for each claim.
We review them by study and by payer, free, with no strings.
3% of collectionsNo setup feeNo contract